Provider Demographics
NPI:1942097720
Name:COOK, SHANNON CHRISTINE
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:CHRISTINE
Last Name:COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:CHRISTINE
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CDCA PRELIMINARY
Mailing Address - Street 1:333 E CENTER ST SUITE 301
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-4142
Mailing Address - Country:US
Mailing Address - Phone:740-796-8835
Mailing Address - Fax:740-796-8835
Practice Address - Street 1:333 E CENTER ST SUITE 301
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-4142
Practice Address - Country:US
Practice Address - Phone:740-796-8835
Practice Address - Fax:740-796-8835
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health